Expert Perspectives

Very Superstitious

Together with morbid obsessions, magical and superstitious thinking makes up one of the stranger and more misunderstood aspects of OCD. When my patients try to describe their symptoms, they preface their explanation with, "I know this sounds crazy, but...." The presence of magical thinking is probably the main reason why many with OCD have been misdiagnosed over the years as schizophrenic. Superstitious thinking makes strange and magical connections between things which logically don't seem to connect in the real world, thus the apparent 'craziness'. Some common examples would be the idea that thinking of an unlucky number can ruin your day, that clothing you wore to a funeral can lead to more unhappiness if you wear it again, or that thinking of the name of a disease will cause you or someone else to get that disease.

OCD is a
Treatable
Condition

OCD Facts

Facts about Obsessive Compulsive Disorder

OCD is a disorder that has a neurobiological basis. It equally affects men, women and children of all races, ethnicities and socioeconomic backgrounds. In the United States, about 1 in 40 adults and 1 in 100 children have OCD. And according to the World Health Organization, OCD is one of the top 20 causes of illness-related disability, worldwide, for individuals between 15 and 44 years of age.

What is OCD?

OCD is characterized by obsessions and compulsions that take up at least an hour a day – but usually longer – and cause significant distress.

Movies and television programs sometimes feature characters who are supposed to have OCD. Unfortunately, films and TV shows often mistake or exaggerate Obsessive Compulsive Disorder symptoms or play it for laughs. People with OCD know it’s no laughing matter.

Obsessions are persistent, uncontrollable thoughts, impulses, or images that are intrusive, unwanted and disturbing. They cause anxiety or discomfort that significantly interferes with normal life. A person who doesn’t have OCD is able to filter out recurring thoughts about germs, for example. But people with OCD who are obsessed with germs can’t stop thinking about being contaminated and may even avoid going into public places.

Individuals who have OCD feel compelled to perform repetitive actions called compulsions, or rituals, in an attempt to relieve the distress caused by the obsessions. For example, a person with an obsessive fear of intruders may check and recheck door locks repeatedly to ensure that no one can get in. Compulsions are frequently overt – something we can see. However, they may also be carried out mentally, such as mental praying or counting. And although we can’t observe them, mental rituals can be every bit as debilitating as those we can see.

Although most people with OCD realize their obsessions are irrational, they believe the only way to relieve their anxiety or discomfort is to perform compulsions. Unfortunately, any relief provided by the compulsions is only temporary and ends up reinforcing the obsession, creating a gradually-worsening cycle of OCD behavior.

Far too often, people with OCD suffer in silence, unaware that their symptoms are caused by a neurobiological problem. Like others who have illnesses such as asthma or diabetes, people with OCD can learn to manage their symptoms. Appropriate treatment produces changes in the brain by weakening old neurological pathways and strengthening new ones, allowing it to function more normally. Fortunately, research continually provides new information about finding ways to understand and treat OCD. And the prognosis for people who suffer with OCD is more hopeful than ever before.

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) provides clinicians with official definitions of and criteria for diagnosing mental disorders. Read the Clinical Definition of OCD

Who is Affected by OCD?

Millions of people are affected by OCD. Current estimates are that approximately 1 in 40 adults in the U.S. (about 2.3% of the population) and 1 in 100 children have this condition.

How Can I Tell If It’s OCD?

Obsessions are persistent and uncontrollable thoughts, impulses, or images that are intrusive, unwanted and disturbing. In response to the distress created by these obsessions, people with OCD perform certain mental or physical compulsions, or rituals. Even though they usually realize that their obsessions are irrational, they feel compelled to carry out these rituals. Unfortunately, relief is only temporary, and the obsessive-compulsive cycle continues. And frustration, anger and hopelessness often result.

What Causes OCD?

What Doesn’t Cause OCD

It’s only human nature to want to know what causes an illness. OCD is often misunderstood and, while researchers are now able to see physical differences in brain function in people with OCD, it’s also important to know what DOESN’T cause this disorder.

Diagnosis

No laboratory test exists that can identify OCD. Mental health professionals frequently use diagnostic interviews to determine the presence of OCD as well as other tools that measure the severity of obsessions and compulsions, the most common of which is the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).

Although not a substitute for a formal evaluation and diagnosis provided by a qualified mental health professional, there is a self-screening test you can take to determine if you have symptoms similar to those associated with OCD and could benefit from professional help.

What Other Conditions May Co-exist with OCD?

A number of other mental health disorders frequently occur with OCD. In fact, people with OCD much more often than not have at least one other co-existing disorder. A trained mental health professional can diagnose and provide appropriate treatment for these conditions as well as OCD. These disorders include:

Anxiety Disorders

Major Depressive Disorder

Bipolar Disorders

Attention-Deficit/Hyperactivity Disorder (AD/HD)

Feeding/Eating Disorders

Autism Spectrum Disorder (ASD)

Tic Disorders/Tourette Syndrome (TS)

Several disorders that tend to co-exist with OCD share many similarities with OCD and are listed in the same DSM-5 category as OCD: OCD and Related Disorders. These conditions should also be treated by a qualified mental health therapist:

What Kind of OCD Treatment Should I Look For?

Getting relief from OCD is possible with treatment that is available today. While there is no cure for the disorder, the most effective, evidence-based treatment for OCD is Cognitive Behavior Therapy (CBT). This treatment is recommended by nationally-recognized institutions such as the National Institutes of Mental Health, the Mayo Clinic and Harvard Medical School.

Choosing A Therapist

Even mental health professionals with impressive credentials may lack the proper training to diagnose and treat OCD. Only a qualified cognitive behavior therapist can provide effective CBT. Before committing to treatment with any therapist, it’s critical to ask questions to help determine if he or she is competent to administer CBT for OCD.

Treatment Challenges

Getting effective treatment can help most people with OCD achieve substantial relief from their symptoms and regain significant control over their daily lives. Unfortunately, getting the appropriate treatment, sticking with a treatment plan and maintaining treatment gains can be challenging. Knowing what to expect ahead of time can make a big difference in your success.

Medication

Although the benefits of medication have not been shown to be as great as those of Cognitive Behavior Therapy, CBT in conjunction with medication is the most effective treatment for some individuals with OCD. Medications can help lower the anxiety associated with obsessions and reduce the urge to perform compulsions. .